Sleep deprivation and burnout syndrome among pre-hospital emergency medical service employees in Slovenia
A cross-sectional study
DOI:
https://doi.org/10.14528/snr.2021.55.4.3052Keywords:
sleep, quality, emergency medical services, sleep deprivation, burnoutAbstract
Introduction: Sleep deprivation and burnout are common in employees who work in shifts, night shifts, overtime as well as those who work under stressful and unpredictable circumstances. The purpose of the study was to explore the quality of sleep, determine burnout level components and investigate the level of these components and their impact on the quality of sleep among employees in pre-hospital emergency medical services.
Methods: A quantitative non-experimental research method was used. Data were collected using a standardized Pittsburgh sleep quality index questionnaire and a standardized Maslach burnout inventory questionnaire. The survey was completed by 204 healthcare professionals. Data were analyzed with univariate and bivariate statistics.
Results: The average Pittsburgh Sleep Quality Index score was 4.97, s = 3.23. Poorer quality of sleep is exhibited by female respondents (57.4 %), respondents who are employed in more overloaded pre-hospital emergency service units (52.3 %) and those who work 24 hours or more (67.7 %). Overall, 17.6 % respondents exhibited high emotional exhaustion, 32.8 % exhibited high depersonalization and 9.3 % exhibited low personal accomplishment. A weak correlation was present between sleep quality and emotional exhaustion (r = 0.381, p < 0.01), depersonalization (r = 0.293, p < 0.01) and personal accomplishment (r = 0.368, p < 0.01).
Discussion and conclusion: Healthcare professionals represent a vulnerable group that is subject to poor sleep quality and burnout syndrome, therefore, the need for empowering them in terms of proper sleep hygiene and burnout prevention is indicated.
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Alshahrani, S. M., Baqays, A. A., Alenazi, A. A., AlAngari, A. M., & AlHadi, A. N. (2017). Impact of shift work on sleep and daytime performance among health care professionals. Saudi Medical Journal, 38(8), 846–851. https://dx.doi.org/10.15537%2Fsmj.2017.8.19025 PMid:28762438; PMCid:PMC5556302
Aydin Sayilan, A., Kulakaç, N., & Uzun, S., (2020). Burnout levels and sleep quality of COVID-19 heroes. Perspectives in Psychiatric Care, 57(3), 1231-1236. https://doi.org/10.1111/ppc.12678 PMid: 33145787
Brand, S., Beck, J., Hatzinger, M., Harbaugh, A., Ruch, W., & Holsboer-Trachsler, E. (2010). Associations between satisfaction with life, burnout-related emotional and physical exhaustion, and sleep complaints. The World Journal of Biological Psychiatry, 11(5), 744–754. https://doi.org/10.3109/15622971003624205 PMid: 20331383
Brum, M. C. B., Dantas Filho, F. F., Schnorr, C. C., Bottega, G. B., & Rodrigues, T. C. (2015). Shift work and its association with metabolic disorders. Diabetology & Metabolic Syndrome, 7(1), Article 45. https://doi.org/10.1186/s13098-015-0041-4 PMid:25991926; PMCid:PMC4436793
Cash, R. E., Anderson, S. E., Lancaster, K. E., Lu, B., Rivard, M. K., Camargo Jr, C. A., & Panchal, A. R. (2020). Comparing the prevalence of poor sleep and stress metrics in basic versus advanced life support emergency medical services personnel. Prehospital Emergency Care, 24(5), 644-656. https://doi.org/10.1080/10903127.2020.1758259 PMid:32314941
Chaves, M. S. R. S., & Shimizu, I. S. (2018). Burnout syndrome and sleep quality among military police officers in Piaui. Revista Brasileira de Medicina do Trabalho, 16(4), 436 –441. https://dx.doi.org/10.5327%2FZ1679443520180286 PMid: 32754658; PMCid: PMC7394527
Dall'Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. H. (2015). Association of 12 h shifts and nurses' job satisfaction, burnout and intention to leave: Findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9), Article e008331. http://dx.doi.org/10.1136/bmjopen-2015-008331
De Simone, S., Vargas, M., & Servillo, G. (2021). Organizational strategies to reduce physician burnout: A systematic review and metaanalysis. Aging Clinical and Experimental Research, 33, 883–894. https://doi.org/10.1007/s40520-019-01368-3
Dilek, A. T. İ. K., Cander, B., Bulut, B., Yazici, R., Ramazan, Ü. N. A. L., & Hasan, K. A. Y. A. (2019). Evaluation of sleep quality with burnout level in emergency medical assistants. International Journal of Health Services Research and Policy, 5(2), 123–136. https://doi.org/10.33457/ijhsrp.712399
Dong, H., Zhang, Q., Zhu, C., & Lv, Q. (2020). Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: A cross-sectional study. Health and Quality of Life Outcomes, 18, Article 116. https://doi.org/10.1186/s12955-020-01374-4
Giorgi, F., Mattei, A., Notarnicola, I., Petrucci, C., & Lancia, L. (2018). Can sleep quality and burnout affect the job performance of shift-work nurses: A hospital cross-sectional study. Journal of Advanced Nursing, 74(3), 698–708. http://dx.doi.org/10.1111/jan.13484
Guadagni, V., Burles, F., Ferrara, M., & Iaria, G. (2014). The effects of sleep deprivation on emotional empathy. Journal of Sleep Research, 23(6), 657–663. https://doi.org/10.1111/jsr.12192 PMid:25117004
Guadagni, V., Cook, E., Hart, C., Burles, F., & Iaria, G. (2018). Poor sleep quality affects empathic responses in experienced paramedics. Sleep and Biological Rhythms, 16(3), 365–368. https://doi.org/10.1007/s41105-018-0156-8
Guyette, F. X., Morley, J. L., Weaver, M. D., Patterson, P. D., & Hostler, D. (2013). The effect of shift length on fatigue and cognitive performance in air medical providers. Prehospital Emergency Care, 17(1), 23–28. https://doi.org/10.3109/10903127.2012.710719 PMid:22925035
Hafner, M., Stepanek, M., Taylor, J., Troxel, W. M., & Van Stolk, C. (2017). Why sleep matters-the economic costs of insufficient sleep: A cross-country comparative analysis. Rand Health Quarterly, 6(4), 11. PMid:28983434; PMCid:PMC5627640
Hammond, E. C. (1964). Some preliminary findings on physical complaints from a prospective study of 1,064,004 men and women. American Journal of Public Health and the Nations Health, 54(1), 11–23. https://dx.doi.org/10.2105%2Fajph.54.1.11 PMid:14117648; PMCid:PMC1254627
Hinz, A., Glaesmer, H., Brähler, E., Löffler, M., Engel, C., Enzenbach, C. … Sander, C. (2017). Sleep quality in the general population: Psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people. Sleep Medicine, 30, 57–63. https://doi.org/10.1016/j.sleep.2016.03.008 PMid:28215264
Honn, K. A., Garde, A. H., Fischer, F. M., & Van Dongen, H. P. (2016). 22nd International Symposium on Shiftwork and Working Time: Challenges and solutions for healthy working hours. Chronobiology International, 33(6), 581–588. https://doi.org/10.1080/07420528.2016.1195632 PMid:27341143
Imo, U. O. (2017). Burnout and psychiatric morbidity among doctors in the UK: A systematic literature review of prevalence and associated factors. BJPsych Bulletin, 41(4), 197–204. https://doi.org/10.1192/pb.bp.116.054247
Javaheri, S., Zhao, Y. Y., Punjabi, N. M., Quan, S. F., Gottlieb, D. J., & Redline, S. (2018). Slow wave sleep is associated with incident hypertension: The sleep heart health study. Sleep, 41(1), 179. https://doi.org/10.1093/sleep/zsx179 PMid:29087522; PMCid:PMC5806562
Jensen, H. I., Markvart, J., Holst, R., Thomsen, T. D., Larsen, J. W., Eg, D. M., & Seest Nielsen, L. (2016). Shift work and quality of sleep: Effect of working in designed dynamic light. International Archives of Occupational and Environmental Health, 89(1), 49–61. https://doi.org/10.1007/s00420-015-1051-0 PMid:25893465; PMCid:PMC4700071
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Kuo, W. Y., Huang, C. C., Weng, S. F., Lin, H. J., Su, S. B., Wang, J. J. … Hsu, C. C. (2015). Higher migraine risk in healthcare professionals than in general population: A nationwide population-based cohort study in Taiwan. The journal of Headache and Pain, 16(1), Article 102. https://doi.org/10.1186/s10194-015-0585-6 PMid:26631235; PMCid:PMC4668247
Lamovec, T., 1994. Psihodiagnostika osebnosti. Ljubljana, Filozofska fakulteta, Oddelek za psihologijo: Znanstveni inštitut Filozofske fakultete.
Lee, A., Myung, S. K., Cho, J. J., Jung, Y. J., Yoon, J. L., & Kim, M. Y. (2017). Night shift work and risk of depression: Metaanalysis of observational studies. Journal of Korean Medical Science, 32(7), 1091–1096. https://doi.org/10.3346/jkms.2017.32.7.1091 PMid:28581264; PMCid:PMC5461311
Li, H., Cheng, B., & Zhu, X. P. (2018). Quantification of burnout in emergency nurses: A systematic review and metaanalysis. International Emergency Nursing, 39, 46–54. https://doi.org/10.1016/j.ienj.2017.12.005 PMid:29361420
Lin, X., Chen, W., Wei, F., Ying, M., Wei, W., & Xie, X. (2015). Night-shift work increases morbidity of breast cancer and all-cause mortality: A meta-analysis of 16 prospective cohort studies. Sleep Medicine, 16(11), 1381–1387. https://doi.org/10.1016/j.sleep.2015.02.543 PMid:26498240
Maslach, C., & Jackson, S-E. (1996). Maslach burnout inventory manual (3rd ed.). Palo Alto, Calif: Consulting Psychological Press.
Maslach, C., Jackson, S. E., Leiter, M. P., Schaufeli, W. B., & Schwab, R. L. (1986). Maslach burnout inventory (pp. 3463– 3464). Palo Alto, CA: Consulting Psychologists Press.
McDowall, K., Murphy, E., & Anderson, K. (2017). The impact of shift work on sleep quality among nurses. Occupational Medicine, 67(8), 621–625. https://doi.org/10.1093/occmed/kqx152 PMid:29040745
Moukarzel, A., Michelet, P., Durand, A. C., Sebbane, M., Bourgeois, S., Markarian, T., Bompard, C., & Gentile, S. (2019). Burnout syndrome among emergency department staff: Prevalence and associated factors. BioMed Research International, 2019, Article 6462472. https://doi.org/10.1155/2019/6462472
Mukherjee, S., Patel, S. R., Kales, S. N., Ayas, N. T., Strohl, K. P., Gozal, D., & Malhotra, A. (2015). An official American Thoracic Society statement: The importance of healthy sleep. Recommendations and future priorities. American Journal of Respiratory and Critical Care Medicine, 191(12), 1450–1458. https://doi.org/10.1164/rccm.201504-0767ST PMid:26075423; PMCid:PMC5442970
O'Leary, K., Bylsma, L. M., & Rottenberg, J. (2017). Why might poor sleep quality lead to depression: A role for emotion regulation. Cognition and Emotion, 31(8), 1698–1706. https://doi.org/10.1080/02699931.2016.1247035 PMid: 27807996; PMCid: PMC6190702
Pagnin, D., de Queiroz, V., Carvalho, Y. T. M. S., Dutra, A. S. S., Amaral, M. B., & Queiroz, T. T. (2014). The relation between burnout and sleep disorders in medical students. Academic Psychiatry, 38(4), 438–444. https://doi.org/10.1007/s40596-014-0093-z PMID: 24683060
Palmer, C. A., & Alfano, C. A. (2017). Sleep and emotion regulation: An organizing, integrative review. Sleep medicine Reviews. 31, 6–16. https://doi.org/10.1016/j.smrv.2015.12.006 PMid: 26899742
Park, S. K., Jung, J. Y., Oh, C. M., McIntyre, R. S., & Lee, J. H. (2018). Association between sleep duration, quality and body mass index in the Korean population. Journal of Clinical Sleep Medicine, 14(08), 1353–1360. https://doi.org/10.5664/jcsm.7272 PMid:30092896; PMCid:PMC6086945
Peršolja, M., Mišmaš, A., & Jurdana, M. (2018). Povezava med neprespanostjo in delazmožnostjo zaposlenih v zdravstveni negi. Obzornik zdravstvene nege, 52(1), 8−17. https://doi.org/10.14528/snr.2018.52.1.186
Schooley, B., Hikmet, N., Tarcan, M., & Yorgancioglu, G. (2016). Comparing burnout across emergency physicians, nurses, technicians, and health information technicians working for the same organization. Medicine, 95(10), Article e2856. https://doi.org/10.1097/MD.0000000000002856 PMid:26962780; PMCid:PMC4998861
Smyth, C. (1999). The Pittsburgh sleep quality index (PSQI). Journal of Gerontological Nursing, 25(12), 10. https://doi.org/10.3928/0098-9134-19991201-10 PMid:10711108
Stimpfel A. W., & Aiken, L. H. (2013). Hospital staff nurses' shift length associated with safety and quality of care. Journal of Nursing Care Quality, 28(2), 122–129. https://dx.doi.org/10.1097%2FNCQ.0b013e3182725f09 PMid:23023189; PMCid:PMC3786347
Stehman, C. R., Testo, Z., Gershaw, R. S., & Kellogg, A. R. (2019). Burnout, drop out, suicide: Physician loss in emergency medicine, part I. Western journal of Emergency Medicine, 20(3), 485–494. https://doi.org/10.5811/westjem.2019.4.40970
Stewart, N. H., & Arora, V. M. (2019). The impact of sleep and circadian disorders on physician burnout. Chest, 156(5), 1022–1030. https://doi.org/10.1016/j.chest.2019.07.008
Sultana, A., Sharma, R., Hossain, M. M., Bhattacharya, S., & Purohit, N. (2020). Burnout among healthcare providers during COVID-19 pandemic: Challenges and evidence-based interventions. Indian Journal of Medical Ethics, 5(4), 308–311. https://doi.org/10.20529/IJME.2020.73
Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D. … Tasali, E. (2015). Recommended amount of sleep for a healthy adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep, 38(6), 843–844. https://doi.org/10.5665/sleep.4716 PMid:26039963; PMCid:PMC4434546
Wilson, W., Raj, J. P., Narayan, G., Ghiya, M., Murty, S., & Joseph, B. (2017). Quantifying burnout among emergency medicine professionals. Journal of Emergencies, Trauma, and Shock, 10(4), 199–204. https://doi.org/10.4103/JETS.JETS_36_17 PMid:29097859; PMCid:PMC5663139
Wolf, M. R., & Rosenstock, J. B. (2017). Inadequate sleep and exercise associated with burnout and depression among medical students. Academic Psychiatry, 41(2), 174–179. https://doi.org/10.1007/s40596-016-0526-y PMid: 26976402
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Woo, T., Ho, R., Tang, A., & Tam, W. (2020). Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. Journal of Psychiatric Research, 123, 9–20. https://doi.org/10.1016/j.jpsychires.2019.12.015
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